has me worried!

I had LD for at least the last 20 to maybe 50 years (I an 54 years old). Was diagnosed with lyme only two years ago.

From age of 18 to around 15 years ago, I gave blood on a regular basis. The reason I stopped giving blood was due to low blood pressure (it got as low as 80/45).

If lyme can be transmitted due to sexual contact, then for sure it can be transferred via blood.

If that the case, I feel terrible for infecting so many people with this dreaded disease.

What should I do, call the Red Cross and give them the facts.

Down in dumps.

Red Cross now has guidelines for Lyme, but probably is still getting some that has spiros because people still don't know they have it.

Getting babesia and ehrlichia passed this way too. There have been journal articles published on these two in the blood supply.

Sorry I missed this post yesterday.

My husband works at a blood donation center
(not at Red Cross). He is not in upper management, nor does he make or affect the medical standards for setting policies.

He said that if contacting the Blood Distribution Center would make you feel better------then naturally you can do that.

However, probably nothing will be done to contact any recipient possibly because it would be impossible to reach everyone.

Bottom line------
Even if they had the manpower to do it, they may not feel responsible for blood 15+ years ago because it was not believed that Lyme is in the blood supply.

In his opinion, the blood is out there. It's gone.

Furthermore, if you did contact the Center, most likely they simply wouldn't believe you. Well, they may be courteous to you, but nothing will be done to correct it.

Why? Because they still don't acknowledge that LD is in the blood supply.

I have reviewed the application for donating blood. I don't have it in front of me.

It asks if you ever had Babesiosis. It does not ask specifically about LD.

I think it asks some other more general questions that might rule out a person with LD from donating. But there is no direct question.

I was shocked when I read over it.

Basically it has to do with their liability.

If I'm not mistaken, I believe I read that a person can be a transplant donor or a bone marrow donor, if your past Lyme Disease was cleared with antibiotics.

Can you believe that one?

Anyone, please correct me if I'm wrong about it. It was really eye-popping news.

If you're curious, you might pull up the CDC's website or even do a search on Lymenet.

I "THINK" CDC acknowledges that it's in the blood supply; you'd need to verify that.

I've read alot in the past on this, but I have poor short term memory for details.

I certainly don't want to cause confusion here.


IMHO, most LLMDs probably believe it's in the blood supply. How could they not?

I'm sure we've all donated at some point in our life. The only solace I can give you is that not all blood is used. It goes bad in 30 days.

That's why after a disaster like 911, they want donors to NOT show up at the same time to donate blood. They want donations to be spaced out.

Perhaps some of your blood was not used.

Sorry, I'm not much help to you. Perhaps some on the board will respond with more details for you.

We all just do the best we can. Eventually, you do have to let go of things you have no control over. And yes, I have thought about it also.

From reading past post on how the medical profession is railroading us, with so many views, I would tend to stay away from donating my organs to somebody.

On my drivers license, I checked the spot on donating my organs.

I just put a sticker on it indicating that I am infected with the LD DO NOT DONATE, can use my body for science.

http://flash.lymenet.org/ubb/Forum1/HTML/021835.html

_________________________________

Vox Sanguinis
Volume 87 Issue s2 Page 120 - July 2004
doi:10.1111/j.1741-6892.2004.00467.x

ORIGINAL PAPER
W01.02
Threats to blood safety posed by emerging protozoan pathogens
D. A. Leiby

Introduction

Blood safety strategies designed to prevent the transmission of
protozoan pathogens have focused almost exclusively on /Plasmodium/ sp.,
the aetiological agent of malaria. /Trypanosoma cruzi/, the agent of
Chagas disease, has received some attention, but only in the endemic
countries of Latin America. For the most part, perceptions of the
potential risks posed by protozoan pathogens have been slow to change.
However, the concept of emerging pathogens has generated a great deal of
interest during the past decade, even among practitioners of transfusion
medicine. It is now clear that new pathogenic agents continue to emerge
due to a variety of factors including immigration patterns, transmission
from animals to humans, and microbial adaptation [1 ]. While the overall
blood safety focus has remained on viruses (e.g. West Nile virus, SARS),
emerging protozoan pathogens transmissible by blood have received
increased attention.

This paper will briefly review two protozoan pathogens that have emerged
as blood safety threats. The first agent, /T. cruzi/, has emerged as a
blood safety risk in non-endemic countries because of immigration and
subsequent changes in donor demographics. The second agent is actually a
group of related organsims, all members of the genus /Babesia/. Like
many other tick-borne pathogens, the geographical distribution of the
/Babesia/ has expanded rapidly leading to an increasing number of human
infections and transfusion cases. Together these agents present blood
safety risks that perhaps have been ignored for too long.

Chagas disease

As already mentioned, Chagas disease or American trypanosomiasis is
caused by /T. cruzi/ which is endemic to portions of Mexico, Central
America and South America. Natural transmission of this parasite to
humans occurs following exposure to a haematophagous reduviid bug
infected with /T. cruzi/. During the course of a blood meal the bug
defecates, passing the infective trypomastigote stage in the faeces. The
parasite enters the skin through the bite wound, conjunctiva or other
mucosal surface and disseminates via the blood stream to smooth muscle,
particularly the heart. In most cases, the ensuing acute disease is
relatively mild, lasting only a few weeks. Thereafter, infected persons
enter an indeterminate phase of disease characterized by intermittent
parasitaemia and elevated antibody titres. Decades later, 20-30% of
infected persons will develop chronic disease characterized by cardiac
and intestinal complications [2 ]. Drug treatment options are limited to
nifurtimox and benznidazole, but both produce severe side-effects and
have limited efficacy.

In addition to natural transmission, /T. cruzi/ is also transmitted by
blood transfusion. In many endemic countries of South America,
interventions designed to interrupt natural transmission of the parasite
have been so successful that blood transfusion has become the primary
transmission route [3 ]. Similarly, in non-endemic countries,
transmission of /T. cruzi/ by blood transfusion is of increasing
concern. During the past 30 years, millions of people have emigrated
from Latin America to the USA and Canada. It is estimated that up to 100
000 of these people may be infected with /T. cruzi/ and thereby
represent an extant reservoir population for transmission of the
parasite by transfusion [4 ]. Indeed, seven cases of
transfusion-transmitted /T. cruzi/ have been reported in the USA (/n/ =
5) and Canada (/n/ = 2), but many more cases likely go unrecognized [5
]. Similarly, while no transfusion cases have been reported from Europe
to date, increased immigration to Europe from Latin America,
particularly through Spain, suggests that transfusion-transmitted /T.
cruzi/ is also an emerging threat to European blood safety.

Nationwide estimates indicate that approximately 1 in every 25 000 US
blood donors is infected with /T. cruzi/ and thus at-risk for
transmitting the infection to blood recipients. Local seroprevalence
rates can be much higher: 1in 9000 Miami donations and 1 in 7500 Los
Angeles donations [5 ]. In Los Angeles, seroprevalence rates increased
significantly during the study period, reaching 1 in 5400 during the
final year of study. The observed increase was attributable to enhanced
recruitment of blood donors from the local Hispanic community. This same
study also revealed that the rate among directed donors, a population
with large numbers of at-risk donors, was 1 in 2400 donations. An
earlier study in Los Angeles reported that for selected high-risk
populations the rate can approach 1 in 1000 donors [6 ]. Thus, while
seroprevalence rates may vary regionally, infected donors can likely be
found throughout the USA at rates that are reflective of the local
at-risk population [7 ]. In Canada and Europe, when and if analogous
studies are done in blood donors, similar findings are anticipated.
Indeed, two transmission cases have been reported in Canada, while 2%
(2/100) of Latin Americans from Berlin were reported to be seropositive
for /T. cruzi/[8 ].

At present, blood bank screening for /T. cruzi/ is conducted throughout
virtually all of Latin America. However, in the USA, Canada and Europe
blood is not screened for antibodies to this parasite despite increasing
numbers of at-risk donors. In the USA where the threat is perhaps the
greatest, the primary obstacle to blood screening is the absence of a
test licensed by the Food and Drug Administration. If and when a test is
licensed in the USA, the most likely intervention to protect the blood
supply is universal screening of all blood products. Strategies designed
to assess risk, either for outright deferral or selective testing, have
been shown to lack sensitivity [9,10 ]. Testing of only first-time
donors, while an attractive idea, would likely increase testing errors
and would be problematic in the case of donors who travel to endemic
areas. Nucleic acid testing would have minimal added value since acute,
window period infections are unlikely to occur in non-endemic countries
(i.e. USA, Canada, and Europe). Leucoreduction has been shown to
incompletely remove the parasite from blood [11 ], and pathogen
inactivation has recently encountered several developmental setbacks.
Thus, for those non-endemic countries seeking a rational intervention,
universal blood screening appears to be the most promising approach to
ensure blood safety.

Babesiosis

Human babesiosis is caused by intraerythrocytic parasites of the genus
/Babesia/, with /B. microti/ and /B. divergens/ the primary agents in
the USA and Europe, respectively. Both agents are transmitted by
/Ixodes/ ticks; /I. scapularis/ is the US vector, while /I. ricinus/ is
the European vector. A variety of other newly described /Babesia/-like
agents (e.g. WA-1, MO-1, EU-1) also cause human disease [12,13 ]. Most
people infected with /Babesia/ spp. develop an asymptomatic or mild
disease that can be characterized by fever, headache, night sweats and
myalgia. Immunocompromised persons, including the elderly and asplenic,
may experience more severe disease complications including haemolytic
anaemia, thrombocytopenia, renal failure and death. Many of these cases
are treated with combinations of quinine and clindamycin or atovaquone
and azithromycin, and in rare instances exchange transfusions are used
to reduce parasitaemia levels [14 ].

The intracellular niche of /Babesia/ spp. provides the parasite with an
ideal mechanism for transmission by blood transfusion. During the past
10 years, there have been at least 40-50 reported cases of
transfusion-transmitted /B. microti/, but the actual number is probably
much higher [15 ]. All transmission cases have occurred in the USA with
the exception of one case in Japan and one in Canada [16,17 ]. The
Canadian case involved a donor who was likely infected during a US
visit. Further, despite its initial discovery in 1996, there have
already been two reported cases of WA-1 transmission. The relatively
high number of transfusion cases is not surprising given the parasite's
ability to survive in stored blood products, its seroprevalence rates in
endemic areas and transmissibility. Indeed, /B. microti/ has been shown
to survive at least 35 days in stored red cell units [18 ].
Seroprevalence studies in blood donors are limited, but rates range from
0�3% to 4�3% for donors in endemic areas of the USA [19-21 ]. A recent
study in Connecticut revealed that the risk of transfusion-transmitted
/B. microti/ is 1 in 1800 transfused red cell units [22 ]. Taken
together, these factors demonstrate the considerable blood safety risk
posed by /B. microti/ and related species of /Babesia/.

At this juncture, options for interventions to prevent
transfusion-transmitted /Babesia/ spp. are extremely limited. Strategies
employing risk-factor questions, such as self reported tick bites, have
been shown to be unreliable [19 ]. Since the Babesia are
intraerythrocytic, leukoreduction is ineffective and as already
discussed, implementation of pathogen inactivation does not appear to be
imminent. Options for serologic screening are limited because beyond the
standard immunofluorescence assay there are few available options,
particularly for a rapid, automated, high throughput test that would be
required for today's blood bank. If suitable tests are developed, it is
not clear that universal blood screening would be the most cost
effective approach since most people infected with /Babesia/ sp. clear
the infections rapidly. Immunocompromised blood recipients, however,
remain susceptible to infection and may benefit from receiving a product
that has been tested and shown to be negative for /Babesia/ antibodies.
A similar approach has been used successfully to prevent the
transmission of cytomegalovirus. Active transmission of /Babesia/ spp.
in North America and Europe indicates that future testing algorithms are
also likely to require a NAT component.

Summary

/T. cruzi/ and /Babesia/ spp. present two remarkably different stories
of how they impact blood safety. /T. cruzi/ is of concern in non-endemic
areas because of increased immigration. In contrast, the /Babesia/ spp.
are truly emerging infectious agents whose endemic range continues to
expand. /T. cruzi/ causes a life-long infection that is thought to be
untreatable, while babesiosis is generally mild and treatable, but can
cause severe disease in the immunocompromised. Despite their
differences, these two emerging protozoan pathogens represent ongoing
threats to blood safety. As for most emerging pathogens, the limited
availability of specific and sensitive tests for research and/or blood
screening has hindered the implementation of effective control
strategies. However, as the geographical distribution of these agents
continues to expand and increasing numbers of transfusion cases are
recognized, the impact these agents have on blood safety will be
increasingly difficult to ignore. Thus, it is not unreasonable to
suggest that within the next five years we will see the implementation
of new control measures for /T. cruzi/ and /Babesia/ spp.

References

1 Institute of Medicine: Factors in emergence. In: Lederberg, J,
Shope, RE, Oaks, SC (eds): /Emerging infections: Microbial threats to
health in the United States./ Washington DC, National Academy Press, 1992
2 Kirchhoff LV: American trypanosomiasis (Chagas' disease). In:
Guerrant RL, Walker, DH, Weller, PF (eds): /Tropical infectious
diseases: Principles, pathogens, and practice./ New York, Churchill
Livingstone, 1999
3 World Health Organization: Control of Chagas disease: Second
report of a WHO expert committee. /WHO Tech Rep Series/ 2002; *905*: 1-109
4 Kirchhoff LV, Gam AA, Gilliam FC: American trypanosomiasis
(Chagas' disease) in Central American immigrants. /Am J Med/ 1987; *82*:
915-20
CrossRef Abstract MEDLINE Abstract ISI Abstract
5 Leiby DA, Herron RM, Read EJ, Lenes BA, Stumpf RJ: /Trypanosoma
cruzi/ in Los Angeles and Miami Blood Donors: Impact of Evolving Donor
Demographics on Seroprevalence and Implications for Transfusion
Transmission. /Transfusion/ 2002; *42*: 549-55
Synergy Abstract MEDLINE Abstract ISI Abstract
6 Kerndt PR, Waskin HA, Kirchhoff LV, Steurer F, Waterman SH,
Nelson JM, Gellert GA, Shulman IA: Prevalence of antibody to
/Trypanosoma cruzi/ among blood donors in Los Angeles. /California
Transfusion/ 1991; *31*: 814-8
Synergy Abstract MEDLINE Abstract ISI Abstract
7 Leiby DA, Fucci MH, Stumpf RJ: /Trypanosoma cruzi/ in a low- to
moderate-risk blood donor population: Seroprevalence and possible
congenital transmission. /Transfusion/ 1999; *39*: 310-5
Synergy Abstract MEDLINE Abstract ISI Abstract
8 Frank M, Hegenscheid B, Janitschke K, Weinke T: Prevalence and
epidemiological significance of /Trypanosoma cruzi/ infection among
Latin American immigrants in Berlin, / Germany. Infection/ 1997; *25*: 355-8
MEDLINE Abstract
9 Leiby DA, Read EJ, Lenes BA, Yund AJ, Stumpf RJ, Kirchhoff LV,
Dodd RY: Seroepidemiology of /Trypanosoma cruzi/, etiologic agent of
Chagas' disease, in US blood donors. /J Infect Dis/ 1997; *176*: 1047-52
MEDLINE Abstract ISI Abstract CSA Abstract
10 Galel SA, Krichhoff LV: Risk factors for /Trypanosoma cruzi/
infection in California blood donors. /Transfusion/ 1996; *36*: 227-31
Synergy Abstract MEDLINE Abstract ISI Abstract
11 Moraes-Souza H, Bordin JO, Bardossy L, MacPherson DW, Blajchman
MA: Prevention of transfusion-associated Chagas' disease: Efficacy of
while cell-reduction filters in removing /Trypanosoma cruzi/ from
infected blood. /Transfusion/ 1995; *35*: 723-6
Synergy Abstract MEDLINE Abstract
12 Homer MJ, Aguilar-Delfin I, Telford SR, Krause PJ, Persing DH:
Babesiosis. /Clin Microbiol Rev/ 2000; *13*: 451-69
CrossRef Abstract
MEDLINE Abstract
ISI Abstract

13 Herwaldt BL, Cacci� S, Gherlinzoni F, Asp�ck H, Slemenda SB,
Piccaluga P, Martinelli G, Edelhofer R, Hollenstein U, Poletti G,
Pampiglione S, L�schenberger K, Tura S, Pieniazek NJ: Molecular
characterization of a non-/Babesia divergens/ organism causing zoonotic
babesiosis in Europe. /Emerg Inf Dis/ 2003; *9*: 942-8
MEDLINE Abstract
ISI Abstract

14 Pantanowitz L, Telford SR, Cannon ME: The impact of babesiosis
on transfusion medicine. /Transfusion Med Rev/ 2002; *16*: 131-43
CrossRef Abstract
MEDLINE Abstract
ISI Abstract

15 Leiby DA: /Babesia/ and other parasites. In: Brecher ME (ed.):
/Bacterial and Parasitic Contamination of Blood Components./ Bethesda,
AABB Press, 2003
16 Matsui T, Inoue R, Kajimoto K, Tamekane A, Katayama Y,
Shimoyama M, Chihara K, Saito-Ito A, Tsuji M: First documentation of
human babesiosis in Japan. (In Japanese with English summary.) /Jpn J
Clin Hematol/ 2000; *41*: 628-34
MEDLINE Abstract

17 Jassoum BS, Fong IW, Hannach B, Kain KC:
Transfusion-transmitted babesiosis in Ontario: First reported case in
Canada. /Can Commun Dis Rep/ 2000; *26*: 9-13
MEDLINE Abstract

18 Mintz ED, Anderson JF, Cable RG, Hadler JL:
Transfusion-transmitted babesiosis: A case report from a new endemic
area. /Transfusion/ 1991; *31*: 365-8
Synergy Abstract
MEDLINE Abstract
ISI Abstract

19 Leiby DA, Chung APS, Cable RG, Trouern-Trend J, McCullough J,
Homer MJ, Reynolds LD, Houghton RL, Lodes MJ, Persing DH: Relationship
between tick bites and the seroprevalence of /Babesia microti/ and
/Anaplasma phagocytophila/ (previously /Ehrlichia/ sp.) in blood donors.
/Transfusion/ 2002; *42*: 1585-91
Synergy Abstract
MEDLINE Abstract
ISI Abstract

20 Popovsky MA, Lindberg LE, Syrek AL, Page PL: Prevalence of
/Babesia/ antibody in a selected blood donor population. /Transfusion/
1988; *28*: 59-61
Synergy Abstract
MEDLINE Abstract
ISI Abstract

21 Linden JV, Wong SJ, Chu FK, Schmidt GB, Bianco C:
Transfusion-associated transmission of babesiosis in New York State.
/Transfusion/ 2000; *40*: 285-9
Synergy Abstract
MEDLINE Abstract
ISI Abstract

22 Cable RG, Badon S, Trouern-Trend Militscher JE, Houghton RL,
Lodes MJ, Persing DH, Eberhard ML, Pieniazek NJ, Herwaldt BL, Leiby DA:
Evidence for transmission of /Babesia microti/ from Connecticut blood
donors to recipients (Abstract). /Transfusion/ 2001; *41*: 12S-3S
Synergy Abstract

I am becomming more convinced than ever that the entire population might already be infected with this bateria anyway.

It is even possible that vaccines and drugs manufactured from animal products are contaminated with the bacteria as well.

Then there are all the unknown viruses and bacteria that we dont know we are even dealing with.